Association Between Pulse Pressure and Carotid Intima-Media Thickness Among Low-Income Adults Aged 45 Years and Older: A Population-Based Cross-Sectional Study in Rural China

Abstract

Worldwide, the stroke burden remains severe, especially for people in low socioeconomic groups. Atherosclerosis is a leading cause of stroke that is attracting increasingly greater attention. Blood pressure, including pulse pressure (PP) and systolic (SBP) and diastolic (DBP) blood pressures, is a traditional risk factor for atherosclerosis; its association with carotid intima-media thickness (CIMT) has also been widely studied. However, published studies have not reported on the relationship between PP and CIMT in low-income adults. Thus, this study investigated the relationship between PP and CIMT in a low-income population, in China. A total of 3,789 people, aged ≥45 years and without histories of stroke or cardiovascular disease, were recruited into this study. B-mode ultrasonography was performed to determine CIMTs. Demographic characteristics, physical examination data, previous medical histories, and laboratory test results were collected for each study participant. Multiple linear regression models were used to analyze the association between CIMT and PP. The mean CIMT was 567.1 μm (males, 583.5 μm; females, 555.7 μm). The SBP, DBP, PP, and mean arterial pressure (MAP) values were all positively correlated with CIMT, in the univariate analysis; PP and MAP showed the strongest correlations. In addition, in three multiple linear regression models, PP was shown to be significantly associated with CIMT; each 1-mm Hg increase in PP resulted in a CIMT increase of ≥0.41 μm (all P < 0.001). Our results demonstrated that, when compared with SBP, DBP, and MAP, PP may be the best predictor of CIMT. Thus, controlling blood pressure, especially PP levels, is vital to decreasing the prevalence of atherosclerosis, especially in this low socioeconomic status population in China.

Comparative Study of Hypertension With Increasing Age of Elderly Postmenopausal Punjabi Women With Cardiovascular Disease: A Cross-sectional Study

“…Both early onset of menopause and a long postmenopausal period are related to increased BP levels (25). BP is recognized to play a crucial role in the manifestation and progression of atherosclerosis (26).…”

“…Luoto et al (31) found a small increase in PP in postmenopausal women with early age at menopause. Furthermore, the findings of Liu et al (26) suggested that to decrease the prevalence of atherosclerosis and the burden of CVD, there is a need for controlling BP and monitoring PP levels. Our findings confirmed significantly high levels of PP in the CVD women of > 45.1 years of menopausal age group in comparison to the CVD women of ≤ 45 years of menopausal age group, highlighting that HTN acts as a remarkable risk factor for cardiovascular illness and risk increases with advancing age.…”

Relationship Between Hypertension and Cognitive Function in an Elderly Population: A Population-Based Study in Rural Northern China

“…This was a population-based, cross-sectional study conducted from April 2014 to January 2015 in rural areas of Tianjin, China. The participants were from a sub-cohort of the Tianjin Brain Study ( 13 , 14 ), which has been described previously. Briefly, approximately 95% of the individuals in this study reported a 2014 disposable income per capita of <1,600 USD ( 15 ).…”

Long-Term Trends in Stroke Management and Burden Among Low-Income Women in a Rural Area From China (1992–2019): A Prospective Population-Based Study

“…The total female population of the region was 7,169 (accounted for 48.0% of all population) in 1992 and 6,815 (accounted for 46.8% of all population) in 2019, respectively. The local illiteracy rate in women aged ≥45 years is as high as 23.4% (24). Moreover, after the 2008 national medical reform in this region, the medical insurance coverage rate increased from 20% (2008) to 100% (2009) (25).…”